The Daily Dish

The old politics of Medicare reform were to demagogue any proposed reform as an attempt to “throw granny off the cliff” for political gain, base motives, or both. These politics were on full display in President Obama’s recent assertion: "Today, we're often told that Medicare and Medicaid are in crisis. But that's usually a political excuse to cut their funding, privatize them, or phase them out entirely -- all of which would undermine their core guarantee.”

The Daily Dish

Today AAF has an event on the “gig economy” and the increasing use of independent contractors, which builds on a recent paper designed to shed light on the magnitude of these labor force developments. For those new to the area, there are three interrelated phenomena: (1) the gig economy – workers with alternative work arrangements, (2) the online gig economy – workers who utilize new technologies, markets and platforms for alternative work arrangements, and (3) the “sharing economy” – goods and services that employ under-utilized assets via online marketplaces or decentralized networks.

Reforming 340B

The 340B drug pricing program requires pharmaceutical manufacturers to provide outpatient medications at steeply discounted prices to certain types of hospitals and health clinics. Intended to provide critical cost savings for hospitals and other entities that provide charitable care for patients without health coverage, eligibility for the largest proportion of entities participating in the program is based on a funding formula that relies on the proportion of Medicare and Medicaid inpatients served by a given hospital. As 340B enters its third decade as part of the federal health funding structure, now is a good time to reevaluate and make sure it is working as intended. This short paper argues that a fundamental change in the formula would better reflect the program’s stated priority.

Medicaid Accounts for 16 Percent of All Health Care Spending in U.S.

In 2014, national spending on health care products and services totaled $3.1 trillion, or $9,695 per person, and accounted for 17.4 percent of our gross domestic product (GDP).  Medicaid enrollment grew by 12.9 percent in 2014, while spending on the program grew by 12 percent (federal and state spending grew 17.7 percent and 3.4 percent, respectively) totaling $503.3 billion and accounting for 16.3 percent of national health expenditures (NHE).   Average spending per beneficiary in Medicaid was 1.4 times greater than spending on individuals with private health insurance.  The chart below provides insight into where that money is going: a large share of the nation’s spending on nursing and retirement care, home health care, and other residential and community-based services are paid for by Medicaid.

Independent Contractors and the Emerging Gig Economy

The rise of the so-called “gig economy” and the increasing use of independent contractors has captured the attention of policymakers. Nontraditional work arrangements are hardly a new development in the American economy, yet there is the perception that smartphone apps and online marketplaces have led to a sharp increase in nontraditional work and even a new class of jobs. The goal of this short paper is to survey the limited available data to shed light on the magnitude of these labor force developments.

Don’t Kill the Independent Contractor

Bill de Blasio’s recent attempt to scuttle Uber’s growth in favor of incumbent taxis and “traffic management” is just the first public foray in the battle against the emerging “gig” economy. At all levels, regulators are planning a barrage of measures aiming to limit independent contractors and elevate the traditional employer-employee relationship. If the de Blasio fiasco has taught policymakers anything, it’s that the gig economy won’t be regulated out of existence.

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